Unintentional injuries are the leading cause of death for children and infants under 14 years of age. Many of these deaths are preventable -not only by prevention behaviors such as installing safety gates and using car seats effectively - but also by administering prompt and effective emergency first aid techniques until advanced care arrives. While programs such as the American Red Cross offer instructor-led courses for families to obtain these skills, many motivated parents, guardians and other caregivers are unable to attend these classes due to difficulties in obtaining and scheduling childcare and transportation. Thus, many families have no first aid skills or rely on folk remedies or television to provide first aid instruction. Additionally, retention of first aid skills is poor and frequent skill reviews are essential to optimizing performance should these skills be needed. In order to reach this underserved population and boost retention of skills, programs are needed that allow families to learn skills on their own schedules, and review pertinent materials when needed. This project proposes to create a multimedia first aid training program for families that can be viewed in Internet/intranet, CD-ROM or DVD formats. The program will cover such basics as pediatric life support (relief of foreign body airway obstruction, rescue breathing, and CPR), controlling bleeding and shock, managing burns and other first aid emergencies. This program will train families in emergency response techniques that could potentially save lives and reduce the severity of outcome from childhood injuries. In Phase I, a prototype Internet-based program was developed for families of children of infants under one- year old. It covered Basic Life Support (BLS) skills as set forth by the American Heart Association. The efficacy of the Phase I program was tested in a 3-condition randomized controlled trial with 91 parents and found to be more effective than an in-person training program and significantly more effective than text-based programs. In Phase II the program will be expanded to include three age groups (i.e., less than 1, 1-8 years, and 9-12 years) and cover both CPR and first aid skills. The entire program will be evaluated in two randomized trials: (a) a large Internet-based "real-world" effectiveness evaluation, and (b) a replication study of the Phase I study, which compared the interactive multimedia program to a text-based program and to a teacher-led program, using direct observation assessment of CPR skills. Public Health Relevance: Unintentional injuries are the leading cause of death for children and infants under 14 years of age. Many of these deaths are preventable, in part by promoting injury prevention behaviors but also by administering effective emergency first aid techniques until advanced care arrives. This project proposes to create a multimedia first aid training program for families that can be viewed in Internet/intranet, CD-ROM or DVD formats, with the ultimate goal of providing life-saving skills to reduce the impact of unintentional pediatric injuries.